Abstract: To ascertain the prevalence of drug abuse among Iranian people a cross sectional household population based survey with census sampling was designed. The Roehampton questionnaire was used for evaluation. Opium abuse was the most frequent substance abuse (17.1%) and opioid dependency was 5.3%. Any one consumed alcohol. Only 4 person had daily use of cannabis, 3 person had daily use of heroin and 8 person had daily abuse of tranquilizers. The most common usage method was inhalation and there was no injection. There was a statistical significant difference between sex and substance abuse. In Iran like other countries drug abuse in male is more frequent than female. The most common substance abuse is opium, it should be noted that in Iran, it is very difficult to obtain LSD, cocaine, or psychedelics, specially, in rural area. Cultural attitude toward substance use quite likely affect the types and patterns of use.
INTRODUCTION
Substance abuse is one of the most complicated health problems worldwide. The consumptive pattern of abuse is varied in other parts of the worlds. Cannabis is the most commonly abused drug in Africa. In North America; cannabis, heroin and cocaine (particularly in the form of crack) abuse are important. In central and South America cocaine constitute the greatest drug problem. Cannabis, heroin, amphetamine and hallucinogens like Ecstasy remain the main drug of abuse in Europe. In Asia, many countries continue to be major procedure of illicit opium and cannabis and abuse of those drugs are the main problem in this region[1,2].
Prevalence of substance abuse is different in the parts of world. Among population aged 16 to 29 in England and Wales the prevalence of substance as follows: Cannabis 24%, Amphetamine 9%, LSD 6%, Magic mushroom 4%, Ecstasy 4%, Cocaine 3% and volatile and other substance 10% totally[3]. An American report was clear 5 to 6% year prevalence of heroin abuse[4]. In 1975 there were 185000 registered addicts in Iran, Moharreri[5] had estimated that the addicted population had been triple since than. Two separated document have reported frequency of addicted population in Iran, according to National Anti Drug Community report, there were 1.5 million addicts among 14 million peoples in pre-revolutionary era[6]. In the other report, there were more than 2 million addicts among 20 million population according to the Drug Control Headquarter in 1997[7]. In the all reports from Iran opium and other extracts' were the most common abuse drug. There was not any general population based survey in prevalence of addiction in Iran and it seems the patterns of abuse are varying in Iran. We designed the current study for evaluating of drug abuse in one of the region in Kerman-Iran as household population based survey.
MATERIALS AND METHODS
Subjects: Samples were selected by census sampling from Dashtkhak-the area in the North East of Kerman Province in Iran with 2100 population up to 12 years old, approximately. A total of 1673 cases responded to questionnaire (response rate was 79.6%). All cases had more than 12 years old.
Instrument and procedure: The Roehampton institute drug survey questionnaire with modifications according to the Iranian culture was used. The questionnaire was completed by subject or a literate relation and collected in the same session.
Statistical analysis: Data analysis was carried out using SPSS-10 software. After description of the data, we used Chi square test and Fisher's exact test for nominal variable. T-test and ANOVA test were used for continuous data and Kruskal-Wallis test was used for ordinal variables.
RESULTS AND DISCUSSION
Of the 1673 subjects, 824 (49.3%) were female and 846 (50.7%) were male. The population aged 12-39 formed 77.3% of the total population. Overall, 893 (53.5%) were married and 723 (43.2%) were single 21 (1.3%) were divorced and 33 (2%) were widow. Table 1 shows occupational status of the subjects. Opium abuse was the most frequent substance abuse (17.1%) and opioid dependency was 5.3%. Subjects who used substances once or more in their lives are summarized in Table 2. The most common usage method was inhalation and there was no injection. There was a statistical significant difference between sex and substance abuse (Table 3). There was no significant difference in substance abuse between age group.
Our data suggested that the prevalence of substance abuse in rural area in Kerman, Iran was 22.5% and addiction rate was 6%. Other studies in Iran have demonstrated the prevalence of substance abuse in different groups of population. Drug abuse among offspring of opioid addicts was 54.4%[8], in a sample of nursing students was 18.5%[9] and among high school students was 21.1%[10].
Substance use was found to be significantly related to sex, with more males than females, suggesting that Iranian culture is almost permissive for males[11,12]. This is in contrast with a research carried out in the United States showing that lifetime use did not vary significantly by sex[13]. There was a non-significant relation between age group and substance use.
| Table 1: | Frequency of occupational state of the samples |
| Table 2: | Frequency of different substance abuse |
| Table 3: | Distribution of substance abuse in both genders |
Cultural attitudes toward substance use affect the type and amount of use. The most common used substances were opium and its residue. It should be noted that in Iran, it is very difficult to obtain LSD, cocaine, or psychedelics. Therefore, it appears that Western attitudes toward substances have had little effect on the pattern of substance use in Iran[8], however frequency of LSD, cocaine, or psychedelics have been increased in Iran in the recent years. Because of limited information on the epidemiology of substance use in the Iranian population, these results can be considered when planning preventive and therapeutic programs.
Acknowledgment
This study was supported by grant from Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. This support is gratefully appreciated.